Macular autofluorescence in eyes with cystoid macula edema, detected with 488 nm-excitation but not with 580 nm-excitation
Macular autofluorescence in eyes with cystoid macula edema, detected with 488 nm-excitation but not with 580 nm-excitation
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DOI：
10.1007/s00417-008-1033-y
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发表时间：
2009-06-01
影响因子：
2.7
通讯作者：
Tano, Yasuo
中科院分区：
文献类型：
--
作者：
Bessho, Kenichiro;Gomi, Fumi;Tano, Yasuo
眼底自发荧光(AF)来源于视网膜色素上皮(RPE)中的脂褐素。由于脂褐素是RPE吞噬感光细胞的副产物，AF成像有望描述视网膜的某些功能方面。在这项研究中，我们报告了3只糖尿病黄斑水肿(DME)和11只视网膜静脉阻塞(RVO)合并黄斑水肿(ME)的黄斑水肿患者的房颤分布。通过标准眼底检查、荧光素血管造影(FA)和光学相干断层扫描(OCT)确定ME。采用488 nm激光激励器(488 nm-AF)的海德堡共聚焦扫描激光检眼镜(CSLO)和580 nm带通滤光片(580 nm-AF)的传统Topcon眼底相机记录房颤。所有受试者均表现为黄斑囊样水肿(CME)，并伴有花瓣样强荧光。在488 nm-AF中，所有眼(100%)的黄斑自发荧光与FA中CME的形状相似。相比之下，在580 nm-AF中，只有一只眼(7%)出现了相应的花瓣状自体荧光。在所有病例中，周边视网膜水肿区未显示与FA渗漏相对应的自体荧光。在CME眼中，488 nm-AF处总是观察到与CME类似的自体荧光，而在580 nm-AF处很少观察到类似于CME的自体荧光。此外，这种CME过度自发荧光仅见于黄斑区。我们推测，CME的自发荧光可能被认为是一种“伪”或“相对”的自发荧光，这是由于CME后黄斑的伸展可能导致黄斑色素(MPS)的侧向移位和随后MPS密度的降低，因为MPS比580 nm-AF更强烈地阻断了488 nm-AF。虽然这种现象不能直接反映RPE功能的改变，但可以作为一种无创性评估或追踪CME的方法。
Fundus autofluorescence (AF) derives from lipofuscin in the retinal pigment epithelium (RPE). Because lipofuscin is a by-product of phagocytosis of photoreceptors by RPE, AF imaging is expected to describe some functional aspect of the retina. In this study we report distribution of AF in patients showing macular edema.Three eyes with diabetic macular edema (DME) and 11 with retinal vein occlusion (RVO), associated with macular edema (ME) were examined. ME was determined by standard fundus examination, fluorescein angiography (FA) and optical coherence tomography (OCT). AF was recorded using a Heidelberg confocal scanning laser ophthalmoscope (cSLO) with 488 nm laser exciter (488 nm-AF), and a conventional Topcon fundus camera with halogen lamp exciter and 580 nm band-pass filter (580 nm-AF). Color fundus picture, FA image and these two AF images were analyzed by superimposing all images.All subjects presented cystoid macular edema (CME) with petaloid pattern hyperfluorescence in FA. In 488 nm-AF, all eyes (100%) showed macular autofluorescence of a similar shape to that of the CME in FA. In contrast, in 580 nm-AF only one eye (7%) presented this corresponding petaloid-shaped autofluorescence. In all cases, peripheral retinal edemas did not show autofluorescence corresponding to the leakage in FA.In eyes with CME, analogous hyperautofluorescence to the CME was always observed in 488 nm-AF, while it was rarely observed in 580 nm-AF. Moreover, this CME hyperautofluorescence was only seen in the macular area. We hypothesize that autofluorescence from CME may be considered as a "pseudo" or "relative" autofluorescence, due to macular stretching following CME that may result in lateral displacement of macular pigments (MPs) and subsequent reduction of MPs density, as MPs block 488 nm-AF more intensely than 580 nm-AF. Although this phenomenon may not directly indicate change of RPE function, it may be used as a method to assess or track CME non-invasively.